TNF and Sepsis: In the present study, it was observed that miR-451a and the Th1/Th2 ratio were both positively related to TNF-α, CRP, the APACHE II score, and the SOFA score in patients with sepsis, which could be explained as that: (a) miR-451a enhanced the inflammatory response through the regulation of multiple signaling pathways [such as nuclear factor (NF)-κB and mitogen-activated protein kinase (MAPK) pathways], thus relating to a positive association with inflammatory cytokines in patients with sepsis (Murata et al., 2014; Li et al., 2019).